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2019 The Korean Society of Sleep Medicine 59
pISSN 2093-9175 / eISSN 2233-8853
Esports is a booming global industry and has been ocially included in the lead-up to the 2020
Olympics in Tokyo. Given that esports is a cognitive based activity, and sleep is well known to be
critical for optimal cognitive functioning, our research group recently proposed that sleep might be
an important determinant of esports performance. e focus of the current review was to expand
our limited understanding regarding the role of sleep in esports by exploring risk factors for sub-
optimal sleep and developing an associated intervention framework. More specically, we aimed to
1) examine how gaming culture and game genre might negatively inuence sleep behaviour, 2) de-
scribe a conceptual model to explain how sub-optimal sleep occurs in esports, and 3) outline sleep
intervention considerations that specically meet the needs of esports athletes. We conclude that
gaming culture and game genre could both impact the sleep behaviour of esports athletes, via cogni-
tive and behavioural mechanisms. Furthermore, adapting Spielman’s three-factor model to esports
may provide a useful and easy to understand conceptualisation for sub-optimal sleep in esports. Last-
ly, sleep interventions for traditional athletes can be suitably modied for esports but must be com-
prehensive and extend from a theoretically grounded conceptual model.
Sleep Med Res 2019;10(2):59-66
Key WordsaaSleep, Esports, Risk factors, Intervention, Performance.
INTRODUCTION
Esports, a form of organised video game competition [1], has developed from relative obscu-
rity into a billion dollar global industry. In 2018 there were an estimated 380 million spectators
worldwide [2], while in 2019 the Fortnite World Cup champion won more prize money than
Novak Djokovic and Simona Halep received for winning Wimbledon [3,4]. More recently, it
has been announced that esports will ocially be included in the lead up to the 2020 Olympics
[5]. Taken together, these developments clearly demonstrate the esports industry’s accelerating
growth, popularity and increasing professionalisation [2]. Yet, despite the transformation esports
is currently undertaking, there is limited performance-based research available to support the
needs of the competitors themselves. us, for esports athletes to reach their peak potential, re-
search is required to address this gap in the literature.
Esports is a cognitive based activity [6] and sleep is critical for optimal cognitive functioning
(e.g., processing speed, working memory, executive functioning) [7,8]. Hence, our research
group has recently proposed that adequate sleep likely plays a key role in esports performance
[9]. Importantly, despite the apparent need for sleep, esports athletes may be exposed to a range
of risk factors for sub-optimal sleep similar to traditional athletes. In our previous paper [9], we
outlined several universal risk factors (e.g., caeine use, pre-competition anxiety, travel) expe-
rienced by all athletes regardless of the sport played. However, other potential risk factors for
https://doi.org/10.17241/smr.2019.00479
Risk Factors and Sleep Intervention Considerations in Esports:
A Review and Practical Guide
Daniel Bonnar, MPsych1, Sangha Lee, MA2, Michael Gradisar, PhD1, Sooyeon Suh, PhD2
1College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
2Department of Psychology, Sungshin Women’s University, Seoul, Korea
Received: November 30, 2019
Accepted: December 16, 2019
Correspondence
Sooyeon Suh, PhD
Department of Psychology,
Sungshin Women’s University,
2 Bomun-ro 34da-gil, Seongbuk-gu,
Seoul 02844, Korea
Tel +82-2-920-7215
Fax +82-2-920-2040
E-mail alysuh@sungshin.ac.kr
ORCID
Daniel Bonnar
https://orcid.org/0000-0001-7528-3023
Sangha Lee
https://orcid.org/0000-0002-7042-2052
Michael Gradisar
https://orcid.org/0000-0002-5146-2657
Sooyeon Suh
https://orcid.org/0000-0003-0644-8634
REVIEW ARTICLE
60 Sleep Med Res 2019;10(2):59-66
Risk Factors and Sleep Interventions in Esports
sub-optimal sleep inherent to esports also warrant attention,
namely, gaming culture and game genre. Neither of these fac-
tors has been examined in relation to sleep although both may
have the capacity to be sleep disrupting. Additionally, as an in-
creasing number of risk factors are identied, it will prove useful
to have a conceptual model outlining how they contribute to the
development and maintenance of sleep disturbances in esports.
Furthermore, given the unique conditions and experiences
that characterise esports, there is a need to consider how sleep
interventions should be designed and delivered to esports ath-
letes. Over recent years there has been rapid development in sleep
management strategies specically designed to address the id-
iosyncratic needs of athletes in traditional sports, with a gener-
al push toward intervention ‘packages’ over isolated strategies
[10]. Although many strategies used within traditional sports
may be generally appropriate (e.g., sleep education, relaxation
techniques) in esports as well, the specic content, aims, style, and
mode of delivery, technology, resources, and evaluation tools
used, should be devised based on the sleep needs of esports ath-
letes. To the best of the authors’ knowledge, no previous paper
has attempted to explore this topic.
e focus of this review is to expand the available scientic
knowledge on risk factors for poor sleep in esports and inform
‘on the ground’ practices regarding the sleep management of es-
ports athletes. Our aims are to, 1) explore how gaming culture
and game genre may negatively impact sleep, 2) describe a con-
ceptual model that outlines the development and maintenance
of sub-optimal sleep in esports, and 3) outline considerations
for sleep interventions tailored specically to the needs of es-
ports athletes.
RISK FACTORS FOR
POOR SLEEP IN ESPORTS
In the following section we focus on two potential risk factors
for poor sleep unique to esports, namely, gaming culture, and
game genre. More specically, we draw from the broader sleep,
sporting, and gaming literature to describe the potential mecha-
nism by which these factors may impact sleep in esports.
Gaming Culture
Culture (dened as the shared attitudes, values, and customs
of a particular group) [11] has been found to have a role in shap-
ing beliefs, which in turn, inuence behaviour, including sleep
[12]. In their review on traditional sports, Burgess and Naugh-
ton [13] outlined how junior athletes who show potential are se-
lected for talent development pathways to help propel them to
elite levels. During this development phase, they are oen af-
forded organisational support in the form of education while
performance-enhancing behaviour, such as adopting adequate
nutrition and obtaining sucient sleep [14], are promoted. Es-
sentially, from a young age, traditional athletes are immersed in
a culture in which performance-enhancing behaviour, informed
by a strong foundation of sports science research, is prioritised
in order to to increase the likelihood of competitive success [13].
Hence, athletes may be more likely to engage in behaviour con-
sistent with this type of culture and the evidence-based beliefs
that develop in response. For example, an individual who has a
belief that they need to keep a regular sleep-wake schedule to ob-
tain adequate sleep may be less likely to stay up late watching
Netix and instead keep a consistent bedtime and wake-up time.
In comparison, the pathway to professional esports is far less
institutionalised, and is predominantly unregulated and unstruc-
tured [15]. Taylor [15] notes that because junior leagues are un-
common, many esports athletes start out as amateur gamers (i.e.,
individual, casual players of video games), and spend their for-
mative years playing online or possibly at LAN (i.e., local area net-
work) events face-to-face against other amateur gamers. In oth-
er words, they exist in an environment that generally lacks the
organisational oversight, support, and educational privileges
received by traditional athletes. Furthermore, they oen belong
to or play with a particular group (sometimes known as a clan
or guild), which can take on its own sub-culture and group norms.
e collective consequence is that unhelpful and dysfunctional
beliefs can develop from this sub-culture. For example, the gam-
ing community oen promotes ‘grinding’ (i.e., excessive prac-
tice, up to 13 hrs p/day) over other health considerations such
as nutrition, physical activity and sleep, presumably due to per-
ceived performance benets (e.g., skill mastery) [16]. Although
the benets of grinding have not been empirically tested, litera-
ture on the diminishing returns of sleep loss relating to cognitive
performance [17] would suggest this strategy is unhelpful.
It should be noted that the esports athlete development land-
scape is making positive progress, albeit slowly. For example,
academies and minor leagues are being implemented at a col-
lege/university and high school level. Moreover, although per-
formance-based research is still in its infancy, this too is begin-
ning to change. However, there is a still a long way to go before
esports athlete development reaches a level of professionalisa-
tion similar to that seen in traditional sports.
Unhelpful and dysfunctional beliefs about sleep amongst
gamers may also be reinforced by other segments of the wider
gaming community such as gaming ‘streamers’ (i.e., an individ-
ual who broadcasts their gaming activity live to online viewers
[18]). Richard Blevins (as known as ‘Ninja’), one of the most
popular streamers in the world who had a total of 478 million
views while on Twitch (a popular streaming platform) streamed
on average for 8.8 hrs at a time and usually started at 2:50 pm
(with a nish time of approx. 11:39 pm) [19]. Furthermore, in
April 2019, a streamer named ‘Edison Park’ streamed content
for approximately 17 hrs p/day over 30 days for a total of 541 hrs
[20]. Social learning theory [21] would suggest that this type of
‘play till you drop’ behaviour modelled by popular and inuen-
Bonnar D, et al.
www.sleepmedres.org 61
tial streamers could serve to de-value the importance of sleep
in the eyes of viewers, which includes future professional es-
ports athletes.
Consequently, it is plausible that in the absence of interven-
tion, unhelpful and dysfunctional beliefs about sleep shaped by
gaming culture during the formative years in amateur gaming
environments could be carried unmodied into professional es-
ports. Hence, at elite levels when optimal performance is para-
mount for competitive success, some esports athletes may be
pre-disposed toward unhelpful wake behaviours that compro-
mise sleep and in turn their performance. Furthermore, if an es-
ports athlete plays in a team with others who hold similar beliefs,
this would also perpetuate poor sleep behaviour. In sum, gam-
ing culture would appear to have the capacity to negatively in-
uence sleep, although empirical research is required to deter-
mine the exact nature and extent of this inuence.
Game Genre
Similar to traditional sports, there are several genres in es-
ports. e most popular genres are real-time strategy (RTS),
multiplayer online battle arena (MOBA), rst person shooter
(FPS) and sports games. RTS is a strategy game genre where the
goal is to win a battle by competing with opponents, securing re-
sources, and producing and operating units [22]. e most pop-
ular game of the RTS genre is Starcra. FPS is a game genre where
the player runs through a three-dimensional space and attacks
the enemy by ring a weapon such as a gun [23]. e most pop-
ular games of the FPS genre are Counter Strike: Global Oen-
sive (CS:GO) and Overwatch. MOBA developed from the RTS
genre [24] and combines a match and a siege (game genre aimed
at attacking a building of a partner). ere are many dierent
MOBA games, but League of Legends (LoL)andDefense of the
Ancients 2 (DOTA2) are the most popular [25]. e sports genre
in esports refer to games that simulate the sporting experience
including sports such as soccer, baseball, golf, basketball, and so
forth. FPS and MOBA genres are team esports, and RTS and
sports genres are mainly individual esports [22].
e sleep of esports athletes may be aected by the type of
genre in which an individual specialises. ere is currently little
empirical evidence to support that some genres have more in-
uence on sleep compared to others. However, the idea of spe-
cic sport genres having dierential eects on sleep has been
examined in traditional elite athletes.
Nedelec et al. [26] proposed that sleep of elite athletes is af-
fected by multiple sport-specic and societal factors. e re-
search in traditional sports has been classied in two ways: one
is by the team format (individual vs. group), and the other is by
the characteristics of the sport. e literature focusing on team
size reported that total sleep time of athletes from individual
sports was 30 minutes less than those who engaged in team
sports, even though they went to bed earlier and woke-up ear-
lier [27]. is result suggests that individual sports athletes may
take more naps during the daytime compared to those who en-
gage in team sports to compensate for shorter night-time sleep
durations. Similarly, it is possible that these results are reected
in esports, where esports athletes engaging in individual genres
who do not have teammates and train individually at home (e.g.,
esports athletes playing FIFA online) can take a nap when they
want to and have more freedom in deciding their sleep schedule.
When it comes to a type (or genre) of traditional sports clas-
sied by characteristics, sleep disorders are more common in
some specic sports than others [28]. For example, sleep prob-
lems such as diculty falling asleep, night time awakenings and
daytime sleepiness are more prevalent in aesthetic sports (i.e.,
gymnastics, synchronised swimming, and gure skating), while
athletes in high risk sports (i.e., sliding, aerial, and motor sports)
report signicantly less sleep issues than the others [29]. Ob-
structive sleep apnea seems to be much more prevalent among
strength power athletes (e.g., rugby) than other athletes due to
a high body mass index (BMI) score [30]. ere are many stud-
ies that have reported on the correlation between game play time
and obesity [31-33]. Ballard et al. [33] reported that the dura-
tion of gaming was positively associated with BMI in a study
including 116 male participants. In a study comprising 10984
participants, Dunton et al. [34] reported a positive association
between gaming and BMI. Considering that esports players spend
more time playing games than regular gamers, it is possible that
some esports players have a high BMI.
Suppiah et al. [35] also reported dierences in sleep patterns
between high-intensity athletes and low-intensity athletes. High-
intensity athletes displayed signicantly greater amounts of slow-
wave sleep, less light sleep, and better sleep continuity. It is di-
cult to ascertain which genre in esports are more intensive than
others because esports does not require a lot of physical move-
ment, and esports athletes are sedentary even when they are in
the middle of the most challenging competitions. Nevertheless,
similar to various shooting disciplines, the physical skills re-
quired for esports rely on ne, rather than gross, motor move-
ments. ese movements are measured as actions per minute
(APM), which is the measure of how many clicks and key press-
es a player can perform in 60 seconds. ese require manual
dexterity to perform and are signicantly and positively corre-
lated with performance in esports [16]. Some esports genres may
require high levels of APM compared to others. For example, in
Starcra 2 (RTS), in which ne control with fast hand speed is
critical to win, elite esports athletes showed APMs up to 500 while
other MOBA genres such as League of Legend (MOBA) does
not require APMs that are as high [36]. While APM is dierent
from the intensity of traditional sports, future research on the
amount and density of ne motor skills used in specic esports
genres and the dierential eects on sleep should be measured
and analysed.
In summary, sleep interventions for esports athletes can vary
based on genre, depending on team size and game characteris-
62 Sleep Med Res 2019;10(2):59-66
Risk Factors and Sleep Interventions in Esports
tics. Particularly, in the case of team esports, it may be necessary
to design sleep interventions that take into account the whole
team, overall schedule, characteristics of the individual team-
mates, and the sleep environment.
CONSIDERATIONS FOR
SLEEP INTERVENTIONS IN ESPORTS
In the following section we initially adapt Spielman’s three-
factor model (3-P model) to conceptualise how sub-optimal
sleep occur in esports, and then based on this model, we outline
considerations for sleep interventions that address the specic
sleep needs of esports athletes.
Using the Cognitive Behaviour erapy for Insomnia
Framework for Esports Athletes
Cognitive behaviour therapy for insomnia (CBT-I) is a non-
pharmacological treatment for insomnia patients and is recom-
mended as the rst line of treatment for insomnia [37]. CBT-I
is usually delivered as a multi-component treatment package
consisting of behavioural and cognitive components delivered
over 4 to 8 weekly sessions. e components consist of sleep
hygiene, stimulus control, sleep restriction therapy, cognitive
therapy, and relaxation training [38]. For a detailed review of each
treatment component [38]. While not all esports athletes will
have insomnia symptoms (e.g., diculty falling asleep or di-
culty staying asleep despite given ample opportunity), using the
CBT-I framework to approach sleep disturbance in these play-
ers may be helpful in both preventing and treating future occur-
rences of sleep disturbance.
CBT-I is based on the 3-P model by Spielman et al. [39], and
proposes that three factors are involved in the development and
maintenance of insomnia: predisposing factors, precipitating
factors, and perpetuating factors. Predisposing factors are vul-
nerabilities that an individual possesses which increase the like-
lihood of developing insomnia, such as genetic predisposition to
sleep disturbance, being at high risk for psychopathology, or cir-
cadian misalignment (i.e., being an extreme morning or eve-
ning type). For esports athletes, this may be strong tendencies
toward eveningness. Additionally, most esports athletes are
younger, which may developmentally predispose them to have
strong eveningness tendencies during the height of their career
[40,41]. Precipitating factors are usually stressful events that
typically result in acute sleep disturbance, such as an exam, loss
of a family member, or a break-up [42]. Instead of exams, es-
ports athletes may experience sleep disturbance before a com-
petition, similar to traditional elite athletes [43]. Additionally,
unlike traditional athletes, esports training (as known as “scrims”)
and matches may take place late in the evening hours, which
may delay sleep timing as is seen with young people’s part-time
work [44]. Frequent travel for matches and adjusting to several
time zones in short periods of time may also be a precipitating
factor for this population. While short-term sleep disturbance
may be a natural stress response, some individuals may begin to
engage in behavioural changes to battle the sleep disturbance
that end up maintaining sleep problems. Perpetuating facts are
maladaptive thoughts and behaviors that are usually initiated
in an attempt to battle sleep disturbance, but end up contribut-
ing to the maintenance of sleep disturbance. For example, esports
athletes may consume excessive amounts of caeine to maxi-
mise game performance and also battle sleepiness. Additionally,
late night training and matches may leave little time for esports
athletes to wind down before bed aer periods of high stress
and excitability. In addition to changes in sleep-related behav-
iours, sleep-related cognitions can also perpetuate sleep distur-
bance. An esports athlete who is on a losing streak may believe
that sacricing sleep to train longer hours may curtail sleep du-
ration, creating a vicious cycle of sleep deprivation, and poor game
performance. e 3-P model suggests that sleep disturbance is
a combination of all three factors, and designing sleep interven-
tions for esports athletes will also need to take a comprehensive
approach and consider all factors.
Current Guidelines for Sleep in Traditional Athletes
Previous studies have investigated sleep interventions in tra-
Table 1. Potential 3-P factors for esports players
Predisposing factor - Strong eveningness tendencies
- Gaming culture
Precipitating factor - Late game and training sessions
- Peak training workloads
- Frequent travel (e.g., jet lag, hotel bed, noise)
- Participating in team esports
- Competition
Perpetuating factor - Drinking excessive amounts of caeine to enhance performance and battle sleepiness
- Lack of wind-down time
- Sleep-interfering activities (e.g., using smart phones in bed)
- Irregular sleep-wake schedule
- Dysfunctional beliefs about sleep (e.g., “I need to stay up longer to perform better”)
Bonnar D, et al.
www.sleepmedres.org 63
ditional athletes to enhance physical and cognitive abilities. A
review by Bonnar et al. [10] categorised sleep interventions for
traditional athletes into three subtypes: 1) sleep extension and
napping interventions, 2) interventions to promote sleep hy-
giene, and 3) post-exercise recovery strategies.
Sleep extension interventions target chronic sleep deprivation
in this population, which recommends spending 910 hours in
bed per day, including naps. Two studies that have investigated
sleep extension and napping interventions both found an in-
crease in total sleep duration and a corresponding increase in
sports performance [45,46]. Similarly, napping interventions
ask athletes to take daytime naps that are placed within the op-
timal circadian window (e.g., midday naps for swimmers) [10].
Interventions that promote sleep hygiene are typically behav-
iours that promote sleep, such as tending to the temperature and
light of the bedroom environment, or avoiding alcohol or stren-
uous exercise before sleep [47]. While sleep hygiene is usually
not recommended as a standalone treatment, studies have shown
that a sleep hygiene intervention can be benecial for increasing
sleep duration for athletes [47].
Studies that have investigated post-exercise recovery interven-
tions involve introducing procedures such as whole-body cryo-
stimulation [48] and red light irradiation [49] with the goal of
indirectly improving nocturnal sleep through these procedures.
While the results of these studies look promising in improving
sleep, more studies are needed to understand the relationship
between these interventions, sleep and performance [10].
e literature on sleep interventions for traditional athletes
is far from comprehensive and further research is needed to in-
corporate specic characteristics of the athlete lifestyle. Speci-
cally, studies investigating the characteristics of esports athletes
and their idiosyncratic sleep needs are necessary in tailoring
sleep interventions for this population. In their study, Baltezarević
and Baltezarević [25] noted that the typical age of esports ath-
letes is between 1725 years, an age that is particularly prone to
strong evening tendencies [41]. Professional team members from
countries such as South Korea and the US typically live togeth-
er to improve training eciency, which may make it challeng-
ing to have a sleep environment that is sleep-conducive. us,
coaches and managers of esports teams who usually make im-
portant decisions about the athletes’ lifestyle and training sched-
ule should be incorporated into planning of sleep interventions
for these athletes. is participation would improve their knowl-
edge of sleep and also monitoring of their own sleep, which is
important in promoting a top-down healthy sleep culture [50,51].
Treatment Guidelines for Sleep Disturbance
in Esports Athletes
Based on the principles of traditional sleep interventions,
guidelines can be adapted to t the lifestyle of esports athletes.
Compared to the traditional approach for sleep interventions,
which usually consist of psychoeducation and/or several week-
ly sessions, a exible approach is necessary to accommodate
training schedules and important matches.
Managing game genre-related eects
Issues that come up in treatment may vary depending on
whether the game genre is team-or individual-player based.
MOBA games such as League of Legends are team-based and
training times (and sleeping times) usually occur similarly for
all team members. us, group interventions may be necessary
for team-based game genres as the team players cannot train
alone. Additionally, game performance hinges on good team-
work strategies and communication between members, and
sleep disturbance or sleep deprivation resulting in poor emo-
tional regulation may be detrimental in working together as a
team [52]. In contrast, individual player games such as FPS
genres can benet both from individual or group formats.
Unconventional training times
Esports athletes oen train late at night. is may be due to
training matches (“scrims”) with teams that are in dierent time
zones and also the delayed sleep tendencies of these young es-
ports athletes. Designing interventions to work within these
time parameters are imperative to a successful intervention with
this population. Additionally, training times may not end until
early morning (e.g., 1:00 am), and esports athletes may not re-
tire to their sleep quarters until aer sunrise. us, practicing
sleep guidelines similar to shi workers such as incorporating
eyeglasses that block blue light aer training may help improve
sleep disturbance [53].
Cognitive therapy specic to esports athletes
Many esports athletes may believe that sacrificing sleep to
train excessively will enhance their performance, or sleeping
less will make them perform better. Additionally, esports ath-
letes may worry about the consequences of not getting enough
sleep before an important match and put too much pressure on
themselves trying to sleep. Psychoeducation based on the sci-
ence of sleep highlighting sleep deprivation studies that have
found reduced response speed (that can correspond to slower
mouse-click speed) may be helpful to players in making the con-
nection between sleep and game performance [17,54]. Addition-
ally, traditional cognitive-behavioural therapy techniques such
as socratic reasoning, cost-benet analysis and behavioural ex-
periments may be helpful in replacing dysfunctional and un-
helpful thoughts about sleep. For example, asking esports ath-
letes to perform a behavioural experiment where they extend
their sleep duration and compare their game performance to
days where they have sacriced their sleep can help challenge
their beliefs about sacricing sleep.
One downside of traditional cognitive therapy is that there is
a considerable amount of time investment required from es-
ports athletes. Based on the adolescent sleep intervention litera-
64 Sleep Med Res 2019;10(2):59-66
Risk Factors and Sleep Interventions in Esports
ture, one of the most common and accepted forms of cognitive
therapy is mindfulness-based stress reduction (MBSR) [55-57].
MBSR introduces simple techniques such as the body scan that
requires little time to teach and learn (12 min) and implement
(15 min per night). us, mindfulness-based techniques that
have more convenient delivery may be an alternative to tradi-
tional cognitive restructuring that can be more conducive with
the schedules of esports athletes.
Importance of wind-down time
Training and participating in game matches for esports ath-
letes requires a high level of attention and concentration, and
can cause stress that results in hyperarousal. Hyperarousal in-
terferes with sleep and can cause insomnia [58,59], so incorpo-
rating a wind-down time to de-arouse in preparation for sleep
is important for esports athletes. Traditional relaxation tech-
niques such as progressive muscle relaxation, breathing retrain-
ing, meditation, and imagery rehearsal can be incorporated into
treatment before bedtime, as well as including the mindfulness
body scan technique.
Adjusting to jet lag
Being an esports athlete entails frequent traveling across mul-
tiple time zones [9], so sleep interventions should incorporate
education on behavioural methods that can be implemented
before, during and aer travel to mitigate the eects of jet lag
(i.e. circadian misalignment) and travel fatigue. To summarise,
current recommendations [60] for traditional athletes suggest
a combination of appropriately timed light exposure and ex-
ogenous melatonin that accounts for the timing of an individ-
ual’s circadian rhythm and the direction of travel (eastward vs.
westward travel). ere may be some benet to phase shiing
prior to departure and during travel, but this needs to be managed
carefully to prevent unintended consequences (e.g., sleep loss).
Motivational strategies
Motivation is critical for behavioural change yet it has been
neglected as a treatment component in sleep interventions for
traditional athletes [10,61]. In esports, motivation to make sleep-
related behavioural change may be a particularly important con-
sideration because the majority of esports athletes are young,
and young people are typically apathetic (and sometimes resis-
tant) to this type of change [62,63]. A recent study by Micic et al.
[64] that evaluated the readiness to change model [65] for ado-
lescent sleep behaviour found that ‘desire’ (i.e., how much an
individual wants/wishes to change), ‘ability’ (i.e., self-perception
of capability to create change), and ‘commitment’ (i.e., intention
or obligation to change) were the best predictive motivational
components of sleep treatment compliance. Hence, incorporat-
ing motivational content may enhance sleep and performance
outcomes.
Early intervention
As noted in the Gaming Culture section, gaming culture may
shape dysfunctional sleep-related beliefs from a young age.
Hence, early intervention in player development via sleep health
education may be one way in which to combat the inuence of
gaming culture, by fostering more helpful sleep related beliefs
and behaviour. Anecdotally, the University of Queensland in
Australia has developed a program for high school students as-
piring to become professional esports athletes. In their program
they included material that aimed to 1) highlight the conse-
quences of insucient sleep, 2) encourage better sleep habits,
and 3) promote a healthy balance between esports and sleep.
Although this program has not been formally evaluated, there
is some evidence that suggests early sleep intervention for chil-
dren and adolescents can produce sleep benets [66,67]. Addi-
tionally, evidence suggests that parental regulation of bedtime
[68] and media [69] can help to protect adolescent sleep; there-
fore including parents in early intervention programs may also
have added utility.
CONCLUSION
e function of sleep in esports has received minimal atten-
tion, yet research from our group and others is starting to pro-
vide critical insight on this matter. We have previously identi-
ed universal risk factors for sub-optimal sleep in esports such
as caeine, travel and pre-competition anxiety. Additionally, in
the current review we propose that gaming culture and game
genre may also play a role in negatively inuencing sleep, via
cognitive and behavioural pathways. Conceptually, adapting
Spielman’s 3-P model to esports is one way in which to formu-
late how these risk factors contribute to the development and
maintenance of sub-optimal sleep. Moreover, from an interven-
tion perspective, we propose that contemporary athlete sleep
interventions can be suitably modied for use in esports but
must comprehensively take into account all 3-P factors (i.e., pre-
disposing, precipitating, perpetuating). Importantly, an esports
sleep intervention needs to be exible, address the practical and
developmental needs of esports athletes, and include key team
decision makers such as coaches and managers.
Acknowledgments
None.
Conflicts of Interest
e authors have no nancial conicts of interest.
Authors’ Contribution
All authors were involved in the formulation of the study concept and de-
sign. Daniel Bonnar, Sangha Lee and Sooyeon Suh jointly completed the
initial dra of the manuscript. Michael Gradisar and Sooyeon Suh edited
multiple revisions of the manuscript.
Bonnar D, et al.
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